The present invention is directed to an intraintestinal bypass graft of the type disclosed in the copending U.S. patent application Ser. No. 538,347, filed Oct. 3, 1983, now abandoned, by Dr. Biagio Ravo, the content of which application is incorporated by reference herein in its entirety, and in the following articles:
Biagio Ravo and Ralph Ger, "Management of Esophageal Dehiscences by an Intraluminal Bypass Tube", Amer. Jour. Surg., Vol. 149, pp. 733 to 738 (June 1985);
G. Castrini, R. Ger, G. Pappalardo, B. Ravo, P. Trentino and M. Pisapia, "Intracolonic By-pass: A New Technique to Prevent Anastomotic Complications in Colon and Rectal Surgery", Ital. Jour. Surg. Sci., Vol. 14, No. 3, pp. 189 to 193 (1984); and
Biagio Ravo and Ralph Ger, "Temporary Colostomy--An Outmoded Procedure? A Report on the Intracolonic Bypass", Dis. Col. & Rect., Vol. 28, No. 12, pp. 904 to 907 (December 1985).
The surgical techniques for implanting the bypass graft of this type are described in detail in the above patent application and articles. Briefly, the proximal end of the thin-walled, highly flexible, water-impervious, cylindrical bypass graft is first sutured to the inner wall of the proximal segment of the sectioned intestine or duct. The posterior wall of the intestine or duct anastomosis is then sutured, after which the distal end of the graft is tied with a suture to an end of a pliable elongated leader (e.g. a rectal tube) and the leader passed through the distal colon segment and then drawn through the patient's anus. When the leader has been fully drawn through the anus an end of the bypass graft is exposed, which allows the graft to be cut to its proper length. Finally, the anterior wall of the intestine or duct anastomosis is sutured. The procedure is the same when the intestine or duct is resectioned with a circular anastomosis surgical stapler (see e.g. U.S. Pat. No. 4,351,466) instead of sutured, except that after the graft is sutured to the inner wall of the intestine, the stapler body is inserted through the anus and advanced to the anastomosis site, the distal end of the graft is tied around the terminal anvil nut of the stapler, the stapler is activated to form the anastomosis all at once, and the stapler body is then withdrawn through the anus, pulling the distal end of the graft along with it (see the aforementioned December 1985 article in Dis. Col. & Rect.).
The graft and procedure described above may be successfully used to protect the anastomosis site in a resectioned intestine or duct and eliminate the need for temporary colostomies. However, the need for the surgeon to securely tie the distal end of the cylindrical graft around the end of the pliable leader, of the stapler anvil nut, can significantly and undersirably extend the total time of the surgical procedure. It is an object of the present invention to alleviate this problem associated with the surgical Procedure described above.